New non-surgical technique for the treatment of an enlarged prostate blocks off arteries that feed the gland, causing it to shrink.
Through tests your urologist and GP will have identified BPH (Benign Prostatic Hypertrophy) or an enlarged prostate, in particular the considerable symptoms it will be causing you. Medication is usually the first stage of treatment and historically if this did not improve things, then a TURP operation would have been indicated.
Now prostate artery embolisation (PAE) is available as an alternative, non-surgical treatment for an enlarged prostate. This new technique does not involve surgery, therefore reducing your in-hospital stay and recovery time following treatment.
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You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
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The procedure takes place in a catheter laboratory designed for specialist interventional procedures that require the use of X-rays. You will be laid on an X-ray table and can be given sedatives if required.
Sterile drapes and equipment are used to keep everything clean. Access to the arteries of the prostate is through an artery in the groin. Local anaesthetic is used to numb the skin and a needle and wire are thread into the artery. A small sheath is then passed over the wire and the wire is withdrawn.
A catheter and smaller micro-catheter is then introduced into the artery via the sheath and placed into the correct position where the arteries supply the prostate. X-rays (angiograms and Dyna-CT) and special X-ray dye are used to identify and visualise the arteries that supply the prostate.
Once the arteries that supply the prostate are identified, fluid containing hundreds of tiny particles is injected through the catheter into these small arteries. These tiny particles then block off the blood supply to the prostate. This is performed on both the right and left prostatic arteries.
The procedure will usually take up to 3 hours and you will be taken to recovery for a short while for routine observations. Once the recovery nurses are happy, you will be transferred back to the ward and lay in bed for a few hours.
If you are suitable for a day case procedure, then you will be allowed home after 4-6 hours or you will be kept in overnight and discharged the following morning.
Once at home, you will be required to rest for 3-4 days and you can be prescribed painkillers if required.
There are just two medium term studies of the results of just over 300 prostate artery embolisation procedures. Around 80% of men will gain symptomatic improvement after PAE with reduction in prostate volumes and an increase in urinary flow rates.
As part of on-going research into PAE your symptom scores and quality of life measurements will be made using pre and post operative questionnaires. The complexity of finding difficult or small prostate arteries may lead to technical failures in around 10% of cases. In case of failure traditional TURP surgery may be offered.
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The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.
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